State Key Laboratory of Genetic Engineering and Collaborative Innovation Center for Genetics and Development, School of Life Sciences, Fudan University, Shanghai, China.
Fudan University Taizhou Institute of Health Sciences, Taizhou, China.
Cancer Epidemiol Biomarkers Prev. 2019 May;28(5):890-899. doi: 10.1158/1055-9965.EPI-18-0827. Epub 2019 Apr 3.
The incidence of cancer was determined by genetic and environmental factors and varied across the world. The discrepancies in cancer profile among Chinese people living in different regions remained obscure.
Chinese people living in urban Shanghai, Hong Kong, Taiwan, Macau, Singapore, and Los Angeles were included in this study. The cancer case data and population data were collected from either the Cancer Incidence in Five Continents Plus database or the regional cancer registry. A rate model was applied to examine the regional differences in cancer risk with Shanghai set as the reference.
From 1983 to 2013, the cancer profiles in most regions were changed. Significant differences in cancer incidence, by sex, period, and age, were detected across regions. The most pronounced disparities were found between Shanghai people and American Chinese in Los Angeles. For cancer site, the most significant differences were detected in prostate, gastrointestinal, gynecologic, oral cavity and pharynx, and brain and central nervous system (CNS) cancers. Specifically, Shanghai was significantly higher in stomach, liver, esophageal, pancreatic, and brain and CNS cancers, while lower in colon, prostate, breast, cervical, and oral cavity and pharynx cancers compared with the other five populations.
Cancer profile was distinct across Chinese populations, which shared a similar genetic background but lived in different regions. The disparities indicate that cancer development was majorly determined by environmental factors, and suggests that region-tailored cancer prevention strategies were warranted.
The cancer patterns in populations sharing the same genetic background were significantly influenced by different living conditions.
癌症的发病率由遗传和环境因素决定，在全球范围内存在差异。生活在不同地区的中国人的癌症谱存在差异，但具体情况尚不清楚。
本研究纳入了生活在城市上海、香港、台湾、澳门、新加坡和洛杉矶的中国人。癌症病例数据和人口数据来自癌症发病率在五大洲加数据库或区域癌症登记处。应用率模型，以上海为参照，检查癌症风险的地区差异。
1983 年至 2013 年期间，大多数地区的癌症谱发生了变化。不同地区的癌症发病率、性别、时期和年龄存在显著差异。上海人和洛杉矶的美籍华人之间的差异最为显著。在癌症部位方面，前列腺癌、胃肠道癌、妇科癌、口腔和咽喉癌以及脑癌和中枢神经系统（CNS）癌症的差异最为明显。具体而言，与其他五个地区相比，上海的胃癌、肝癌、食管癌、胰腺癌和脑癌和中枢神经系统癌症的发病率显著较高，而结肠癌、前列腺癌、乳腺癌、宫颈癌和口腔和咽喉癌的发病率显著较低。
尽管具有相似的遗传背景，但中国人的癌症谱存在明显差异，这表明癌症的发生主要受环境因素的影响，需要制定针对特定地区的癌症预防策略。
具有相同遗传背景的人群的癌症模式受不同生活条件的显著影响。
